Please respond to discussion below using current APA edition and 2 scholarly references. Must be at least 150 words.
This week I began my first week of adult gerontology preceptorship at my clinical site. It is a primary care family practice clinic, where they care for patients across the lifespan. However, they do not address the needs of babies and infants. I completed my previous clinical rotations there and continued for this rotation. I didn’t experience any notable challenges this week. I have learned the importance of speed and efficiency in addressing patient concerns/needs.
This week an 86-year-old male presents to the clinic for follow up. During this visit he complains of lower right back pain that radiates down his right leg. He admits that his pain level at times from a 0-10 scale borders from 8-10 and causes limitation in his mobility and performance of daily activities. He states that the pain comes and goes but is more pronounced with activities. He admits to a medical history of hypertension, prediabetes, lumbago pain, and BPH. He admits to taking Losartan, Amlodipine, Gabapentin, Aspirin, and Tamsulosin. His physical exam revealed a score of 10 pain level and physical limitations in ambulation and movements. He weighs 175 pounds and is 5”6. His vitals are BP 136/60, 97% saturation on room air, 98.2 F temperature, heart rate of 75 and respiratory rate of 18.
Differential diagnoses for this patient include acute pain, lumbago with sciatic pain, muscle strain, herniated disc. Acute back pain is referred to pain that extends from the lowest rib to the buttocks (See et al., 2021). This pain can at times extend downward to include the lower limbs (See et al., 2021). There is a high association of inflammation and low back pain found in individuals with lumbar disc herniation (Cunha et al., 2018). Inflammation is directly linked with symptoms that stimulate nerve fibers that cause pain (Cunha et al., 2018). Back strains and sprains usually occur because of physical overactivity (Alzahrani et al., 2019).
Today in the office he was given Toradol 60 mg IM for his pain. This visit was centered around addressing the patient’s pain, health promotion and preventative measures that can be instituted that would promote positive health outcomes. Patient education was provided to the patient on the importance of dietary and lifestyle alterations that must be implemented immediately. Labs were performed. The patient will return in 1-2 weeks for lab review and would be notified if an earlier visit was necessary.
